title: Therapy of endocrine disease: Impact of iodine supplementation in mild-to-moderate iodine deficiency: systematic review and meta-analysis.
abstract: BACKGROUND
  Although the detrimental effects of severe iodine deficiency are well recognised, the benefits of correcting mild-to-moderate iodine deficiency are uncertain.
  
  
  OBJECTIVE
  We undertook a systematic review of the impact of iodine supplementation in populations with mild-to-moderate iodine deficiency.
  
  
  METHODS
  We searched Medline and the Cochrane library for relevant articles published between January 1966 and April 2013, which investigated the effect of iodine supplementation on maternal and newborn thyroid function, infant neurodevelopment and cognitive performance in school-age children. The quality of studies was graded and eligible trials were evaluated in the meta-analysis.
  
  
  RESULTS
  Nine randomised controlled trials (RCTs) and eight observational studies met the inclusion criteria. Controlled trials on infant neurodevelopment were lacking; gestational iodine supplementation reduced maternal thyroid volume and serum thyroglobulin and in some studies prevented a rise in serum thyroid-stimulating hormone. None of the intervention trials recorded an excess frequency of thyroid dysfunction in contrast to observational studies. A pooled analysis of two RCTs which measured cognitive function in school-age children showed modest benefits of iodine supplementation on perceptual reasoning (standardised mean difference (SMD) 0.55; 95% CI 0.05, 1.04; P=0.03) and global cognitive index (SMD 0.27; 95% CI 0.10, 0.44; P=0.002) with significant heterogeneity between studies.
  
  
  CONCLUSIONS
  Iodine supplementation improves some maternal thyroid indices and may benefit aspects of cognitive function in school-age children, even in marginally iodine-deficient areas. Further large prospective controlled studies are urgently required to clarify these findings and quantify the risk/benefits of iodine supplementation in regions previously believed to be iodine sufficient such as the UK.
authors.affiliation: Thyroid Research Group, Institute of Molecular and Experimental Medicine (IMEM), Cardiff University School of Medicine, Cardiff University, Cardiff CF14 4XN, UK.
authors.forename: Peter N
authors.initials: PN
authors.lastname: Taylor
authors.forename: Onyebuchi E
authors.initials: OE
authors.lastname: Okosieme
authors.forename: Colin M
authors.initials: CM
authors.lastname: Dayan
authors.forename: John H
authors.initials: JH
authors.lastname: Lazarus
mesh_terms: D000328:Adult; D002648:Child; D002657:Child Development; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control; D004032:Diet / Q000009:adverse effects; D019587:Dietary Supplements; D019317:Evidence-Based Medicine; D005260:Female; D047109:Fetal Development; D006801:Humans; D007223:Infant; D007455:Iodine / Q000172:deficiency* / Q000627:therapeutic use*; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D055495:Neurogenesis; D010468:Perceptual Disorders / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D012720:Severity of Illness Index; D017673:Sodium Chloride, Dietary / Q000627:therapeutic use*; D013961:Thyroid Gland / Q000196:embryology / Q000503:physiopathology*
chemical_list: D017673:Sodium Chloride, Dietary; C034024:iodized salt; D007455:Iodine